Please read through the Q&A before posting a question. This will help everyone to not have duplicate questions. Thank you!
If you still can’t find a related answer, then you are welcome to ask your question in the comments section below.
See our BLOG Category on Sleep Apnea for articles and more information.
Q&A
Is sleep apnea a disqualifier?
What is EDS? Is EDS a disqualifier?
If I’m overweight do I have to have a sleep apnea test?
Is there a BMI limit for commercial drivers to pass the DOT physical?
What does neck size have to do with the DOT physical exam?
What does snoring have to do with the DOT physical exam?
I take Restoril for sleep. Will that be a problem for the DOT physical?
Is sleep apnea a disqualifier?
Sleep apnea does not necessarily disqualify you for medical certification. Treatment with a CPAP machine and some basic lifestyle changes can help you get a restful sleep and maintain your commercial driver’s license. Many drivers who have suffered fatigue for a long time , and then were diagnosed with sleep apnea and treated, report that they’ve felt like a new person since they’ve been on a CPAP machine.
You will need to bring a medical opinion letter from your treating physician before you can be considered for DOT medical certification.
Narcolepsy is a disqualifier regardless of treatment, because it poses a risk of EDS and may also bring on sudden muscular weakness.
What is EDS? Is EDS a disqualifier?
EDS stands for Excessive Daytime Somnolence or Sleepiness. Because fatigue and driver drowsiness are safety concerns, the medical examiner must rule out EDS before certifying. A driver who has EDS will be temporarily disqualified until the condition is being successfully treated. The medical examiner will want to see a medical opinion letter from the treating physician before issuing a medical card.
If I’m overweight do I have to have a sleep apnea test?
No. Being overweight, of itself, does not mean that you should be tested for sleep apnea. Overweight is an initial indicator for the medical examiner to make sure that other conditions aren’t present which may affect your ability to safely operate a CMV.
The medical examiner will evaluate your overall physical condition and health history. The medical examiner has a responsibility to have you tested for sleep apnea if he/she has reasonable suspicion that you may have sleep apnea. Many people suffer for years from sleep apnea and don’t know they have it until a doctor catches the symptoms.
Sleep apnea is not only associated with sleep deprivation. It’s also associated with an increased risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, and diabetes. The most serious complication is a severe form of congestive heart failure. Sleep apnea sufferers also have a 30% higher risk of heart attack or premature death than those unaffected.
Is there a BMI limit for commercial drivers to pass the DOT physical?
There are currently no set specifics on BMI measurement in the DOT regulations. However, companies may set their own policies and have their own standards for these indicators, which may disqualify you to drive for that particular company.
What does neck size have to do with the DOT physical exam?
Neck size, weight, and BMI are all just indicators that the medical examiner looks at to determine if you may have a condition such as sleep apnea that would impact your ability to safely drive a commercial vehicle now or for the period for which the medical card may be issued. There are currently no set specifics on these measurements in the DOT regulations.
Other indicators of potential obstructive sleep apnea are enlarged tonsils and large tongue volume. Individuals with low muscle tone and soft tissue around the airway (e.g., because of obesity) and structural features that give rise to a narrowed airway, are at high risk for obstructive sleep apnea.
Because sleep apnea is associated with increased risk of other debilitating diseases, it’s the responsibility of the medical examiner to rule out suspicion of sleep apnea, for driver certification.
What does snoring have to do with the DOT physical exam?
Snoring, in combination with obesity, can be highly predictive of obstructive sleep apnea risk. That said, even the loudest of snorers may not have a breathing obstruction. The sign that is most suggestive of sleep apnea occurs when snoring stops. If both snoring and breathing stop while the person’s chest and body try to breathe, that is literally a description of an event called an ‘apnea’. When breathing starts again, there is typically a deep gasp and then the resumption of snoring.
For the DOT physical exam the medical examiner evaluates your overall physical condition and health history to determine if there are signs of a medical condition that may affect your ability to safely drive a CMV. If the medical examiner has reasonable suspicion that you have sleep apnea you may have to go for an overnight sleep test called a polysomnogram before you can be further considered for certification.
I take Restoril for sleep. Will that be a problem for the DOT physical?
The medication, Restoril, may cause side effects: Hangover effect, drowsiness, dizziness, nausea, and vomiting.
These will all be questions the medical examiner is going to ask you about. This medication is usually used on a short term basis and not for a long term sleep aid. So it will depend on the type of driver you are and would be a serious consideration within the DOT examination.
You will need a medical opinion letter from your prescribing doctor explaining his reasoning for the use of this medication and why he feels it would be safe for you to drive a commercial motor vehicle OTR. Otherwise this could be a disqualifier for OTR drivers.
Can’t Find An Answer For Your Question?
If you have a question that you feel has not been answered, scroll down to the Questions and Comments box and post your question.
- Before posting, please make sure you are on the appropriate Category page, so that relevant questions and answers can be found by other drivers too.
- To save us all from zombie spammers, your question will not appear on this page until it has been approved.
- Trucker Docs™ will answer your question as soon as possible.
- Visit this page again soon to see our response.
P.S. Your email address will not be published.
Your comments are also welcome.
My husband went to get his dot physical. He uses a cpap machine. The dr said he just met the requirement with the 70%. Then he had to get a clearance letter from his oncologist, hes revovered frm cancer. So he goes back to physical place. Now its a different dr and this one will not pass his physical because his sleep complience is exactly what the requirement is. Can they do that?
@Bobbie
Yes and no. If the examiner is sticking to the absolute letter of the regulation and he can support his decision, then yes he can do that.
Most of the regulations are designed for strict guidelines, but he can also support his decision to pass you with proper documentation from his sleep doctor. Get a letter/medical release form completed by his primary sleep doctor and you shouldn’t have any real problems. Good Luck
@ Bobbie. Tell your husband phycian to schedule him for a MWT to check for complience with his CPAP. That should be able to help.
Rashida
Will I be disqualified fkr a medical card if I take medication for restless leg syndrome and have sleep apnea?
@Richard
Sleep apnea has its own set of rules. See a number of blog posts on sleep apnea.
If you are taking a medication for restless legs, then you should have your primary medical doctor complete a medical release form for you and take it with you to your DOT examination. This will answer any questions that the examiner may have. You shouldn’t have any issues if your only condition is restless leg syndrome. Good Luck.
Can being on a cpap keep me from being issued a 2 year dot medical card?
@Lineman1
Yes, one year is the max for a driver using a CPAP.
I am about to renew my dot physical in new jersey my dr said I will have to have a sleep study because my bmi is 38 and he said the law says anything over 35 you have to have the study is it true and legal thanks
@Gregg
No, this is not true. Ask to see the law. He can’t provide it to you, then go elsewhere.
For more information on the confusion about this issue, read our articles on sleep apnea.
I took a physical and met all requirements to operate a cmv. The cme still withheld my medical card pending a sleep test, and issued me a 90 day medical card. I want to get a second opinion. My question is, do I turn in the long form for the first physical. Or take a second physical then mail in the results of that physical?
@John
Your information has already been sent to the FMCSA for you. So what ever medical certificate you have in your pocket is what you have right now. If you go for a second opinion and the CME does not feel that you need a sleep study and he gives you an different length card, then that will be your new card for both FMCSA and the state.
In PA, just going for re-cert medical. Have sleep apena and use the CPAP. Can they mandate that you must use it for a certain number of hours per day. What useage numbers are actually law.
Can the medical keep me from a D.O.T. card for over 3 months if all they did was recommend a sleep study? Blood pressure is good and everything else checks out but say I can only geta 3 month card until I take sleep study
@David
I would ask your examiner to show you the law or regulation regarding this issue. I have drivers across the country running into this problem. There is no such law/regulation regarding this.
Some of the drivers are taking their case to court and winning because there is no such regulation. So unless there is some other reason other than “he heard it somewhere” then it’s time to call these guys to the carpets.
my husband is going through the same thing, only he had the sleep studies and the surgery back in the 90’s now after all these years of driving and having no issues the examiner wants him to re do the entire sleep study stuff and he has no insurance so that isn’t gunna work. He was given a 90 day renewel and that it. This just happened this week
@Keeley
Having had the surgery so long ago and having no issues does raise some questions about the CME’s understanding of the rules and regulations of the FMCSA.
After 30 days I would go to another CME for my examination, and find one that understands the issue. There is no need to redo anything. Good Luck.
I am self employed, own ONE old 16′ Ryder truck and the DOT crapola I’ve had to go through to drive 2500 miles a year is ludicrous at best.
But it’s time to renew my health card.
I have been using a CPAP machine for years and though I hate the thing, I do sleep better and it does help relieve my sleep apnea.
Went to a “DOT registered” place of compliance today. Took paperwork for 90 days of data recorded from the CPAP, proof of a very recent visit to a pulmonary/sleep specialist to confirm usage, and the same info from a Dr. who originally suggested the sleep study (his records went back MORE than a year).
Still, I was told by this current examiner that we had some problems.
The main problem was that due to DOT regs I need to get another sleep study.
If I’m reading correctly here, that is BS.
Am I correct?
Erich
You’re right, it’s BS. Find another examiner who knows the FMCSA handbook. Good Luck.
If you need to get the sleep study go for it its not the end of the world you will maintaine you’re cdl except you will need to have it done yearly and present a letter from you’re sleep doctor that you’re compliant with the cpap machine you will be fine and feel better if machine is needed
DON’T go to one ‘o these occupational med centers {concentra, quest, etc.}
Those SOB’s make their own rules as they go along and require payment up front.
Find a lax chiropractor that will take payment AFTER your exam {most do}.
They will work with you and cut you some slack.
And if I don’t get at least a one year card the doctor don’t get paid – period!
I just had my physical done today. I’m over weight, type II diabetic and have a large neck. He gave me a 60 day card, saying he wants me to do a sleep study before extending it. I had a study done about 3 years ago saying no apnea. I told him this, my health hasn’t changed much, how long is the study good for? Do I really need to do it again?
@Jeff
There are no rules/regulations or guidelines set forth by the FMCSA on sleep apnea screening. See our blog articles on sleep apnea for more information.
The examiner has to look at your overall health and assess your fitness for duty as a commercial driver. With a number of factors that point to a risk for sleep apnea, he is within his rights to assert this caution.
You may do well to keep going to the same medical examiner each time you re-certify, so he can assess your current condition to your previous condition, and maybe you won’t keep running into this problem. You may also look at ways to improve your health so this does not become a problem in the future.
Remember, the FMCSA or NRCME has not made any decisions yet on guidelines on Sleep Apnea yet.
I have had several drivers come to me that have been taken off the road because they have a large neck measurement — and that is incorrect.
There are more factors to be looked at than a large neck.
Another driver was told he had sleep apnea because his tongue was to short.
WOW.
My husband has a CDL and his medical cert expired 1 day ago. He went to reg doc and then when we went to upload his new cert to the FL DMV, we read the new regulations about using an MD in the National Registry. Today he went to Occ Health and filled out the paperwork to have a physical (again). He uses a CPAP and has for years. The last time he was at the doctor for an exam was in 2012. At that time he received a new machine. Today he was told, because he answered yes to the question about trouble breathing while he sleeps (just being honest) the MD asked him if he had been tested. He told the MD he had a machine. The MD at Occ Health told him he needs to go to the MD that prescribed his machine and get a letter stating he is in compliance. Well, that doctor is now saying he needs a new sleep study. The nurse said there are people waiting up to 3 months for a study. He told her that their jobs most likely do not rely on getting the test. How are these drivers supposed to pay their bills? Not to mention by the time the study is done, they won’t have a job with their company anymore. What a money making scam this has turned out to be. Anyway, is there a way for him to get a temporary 90 day card in the event this happens?
@Deb
The DOT examiner can, if he chooses to, issue a 90 day card while waiting for the test.
i use a cpap because was diagnosed with mild sleep apnea. went for dot physical july 2nd 2014. passed physical with no problem but, the PA wants me to get a multiple sleep latency test and said it is required by law. my pcp is also certified to give cdl physicals and said it isnt. the pa wont give my physical card till it is done. Who is right?
@Doyle
Trust the doctor and question the PA.
I have complex sleep apnea and was just diagnosed. I use a CPAP. How long does it have to be under control to pass a DOT physical?
@Shantel
The main wait period is for a 3 months, once you’re on the CPAP.
This could be longer if they have difficulty stabilizing your condition.
Once it’s stable then you will have to get a new medical certificate every year.
Good Luck.
I have a CDL license in Pennsylvania, some of my coworkers/other drivers have warned me about the new physical requirements in PA DOT and the fact that if you even look overweight the medical examiner has been sending drivers for sleep apnea tests? Is there anyone out there who has experienced this type of treatment during their exam? I’ve researched this topic and being overweight isn’t necessarily a reason for sleep apnea tests, but everyone that I’ve talked to has said that they were required to take sleep apnea test, testing is very tough on this subject.
@Ken
Some examiners were financially vested in the whole sleep apnea thing when they thought it was going to become a regulation.
It never did, FMCSA was forced to re-think its position on the issue and retracted its original point.
So now these doctors and companies are stuck with sleep facilities and no one to pay for them, so anything will trigger the need for the test.
Just ask them to show you the law or regulation that states that sleep apnea testing is required by the FMCSA and on what basis. They can’t show you the reg, so it’s time to walk out and get your examination done elsewhere.
my DOT medical card will expire before I can get a sleep test, can I get a temporary 90 day Medical card while sleep test is being completed. My DOT Doctor is also my primary care Dr. He didn’t seem to know and now my medical card is expiring before I can get appt for sleep study completed. I am a school bus driver.
@Louis
Not real sure why you would need a sleep study test done.
But your doctor can, if he wants, give you a 90 day card while your testing is being done.
New regulation – May 21, 2014 – Your DOT doctor must be certified on the National Registry (so he would know this).
My Primary DR is DOT Certified, he says because I am diabetic and overweight (17 1/2) inch neck he wants sleep study. If diagnosed with sever sleep apnea is it going to pass with CPAP. He says he can only issue 30 day, while study being done, then a 60 for CPAP, then a year if all pass.
@Louis
He seems to be very cautious about you getting the sleep study done as soon as possible. But most of what he is doing is within his scope of evaluation. Get the test done and go from there.
You should have been on a one year card with your diabetes anyway. Good Luck.
If I need sleep test due to neck being 17 inches, can I get 90 day temporary until testin is complete?
@Louis
That all depends on the DOT/CME examiner.
Some examiners are letting the drivers continue to work for 90 days until the test is done, some are being unreasonable.
And did they base the need for the sleep test based ONLY on your neck size? Because there is no such ruling from the FMCSA regarding neck size and sleep studies being mandatory.
My husband who is 53yrs old just went for a physical to renew his medical card, in the State of Texas. They told him because he was over 50 and his neck was 17.5 he had to do the sleep study. I’ve been told by others that the age criteria is 55 and if neck is over 17in. Which is correct?
@Dawn
Neither is correct. FMCSA currently does NOT have any ruling which requires this type of screening.
You should ask to see the law in writing. Since it does not exist, then I would ask where they got this information or go elsewhere.
I drive a school bus and was sent for sleep apnea test. It came back as mild sleep apnea. Am I required to use the cpap machine or can I use something else? I tried the machine and it keeps me awake. isn’t it supossed to help you sleep? I don’t think the test that you get can possibly be accurate. I got pretty much no sleep when I went for the test and the machine made me choke terribly.
@Lynn
I would check with your state.
You are not driving interstate and your condition is listed as mild, so you may be able to use another system. Just do a little research on the subject and check with your state requirements.
I drive a school bus, are the Epworth sleepiness scale readings the same for rig drivers?
@Molly
I believe so, but don’t quote me on this one until further research is done.
I would check, online, in the FMCSA guides for the answer.
What happens if you fail your physical?? Do they take your card away right there even if you have more time left on it?? Do they report your fail to anyone?? Is there a retest waiting period??
@Dan
With the new FMCSA regulations now in place, your failure during a DOT physical (not being medically fit to operate a CMV) is reported on the FMCSA website for the NRCME.
There is no established waiting period.
Once you have the condition which caused you to fail under control, you can go and get another DOT examination.
My Husband is a CDL driver – local, no OTR. His company is making a sleep apnea test mandatory. They are conducting the test at a hotel – 5 drivers at a time – and if you refuse, you will not be allowed to work. He has a current medical card – valid until July 2015. Can his employer force him to take a sleep apnea test as a condition of continued employment?
@Karen
It’s a tough call.
If the company is making it a company policy across the board and they are paying for the testing, then I believe they can make such a request.
But I am not a lawyer, so check further if you need to. There may be other areas of employment conditions that are affected by these actions.